Vallabhaneni, Jaya
Vallabhaneni, Jaya is an individual health care provider with primary practice located at 3273 Shallowford Rd Ne , Atlanta GA 30341-3632. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Vallabhaneni, Jaya can be contacted via phone (770) 455-0628.Contact Information
Primary practice address
3273 Shallowford Rd Ne
Atlanta GA 30341-3632
Phone: (770) 455-0628
Fax: (770) 451-7521
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN 012273 | Georgia |
Profile Details
| NPI number | 1407846793 |
|---|---|
| LBN Legal business name | Vallabhaneni, Jaya |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Mar 21st, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407846793 | NPPES |
| Georgia | MEDICAID | 853472301B |
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